What medications would help a patient get rid of the red, dry, and itchy rash on the back of his neck?

Hello,

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As per the history and image provided (attachment removed to protect the patient's identity), they appear as Tinea corporis. Tinea is a fungal infection affecting various areas of the body and spreads fast, and is contagious. Although it is not a life-threatening problem, it is a skin infection that completely goes away, so do not worry.

Tinea appears due to multiple reasons, including sweating, decreased immunity, contact with an infected individual or sharing the infected person's belongings, and stagnation of moisture, especially after a bath when complete towel drying and airing is not ensured. They appear as red to white round, oval, or ring-like lesions, which may contain white scales and present with itching, pain, inflammation, and discomfort.

I suggest you do the following:

1. Ketoconazole soap is to be used twice daily. It has to be used after lathering with water and applied only on the affected parts and not on the normal skin. Keep the lather on the affected area for five minutes and wash it off. In the rest of the areas, a normal soap can be used.
2. Terbinafine cream is to be used twice daily on the affected areas alone. After taking a bath with soap, dry the areas well. There should not be any moisture, and then apply the cream. Make sure to wash your fingers well with soap after applying the medication on the affected area, or you may also use gloves to apply and make sure the cream is well absorbed.
3. Terbinafine dusting powder has to be used in the afternoon and evening. Dust the powder on the affected area. Moisture should not be kept stagnant.
4. Take the capsule Itraconazole 200 mg once daily after food for four weeks, preferably at night.
5. Continue to consume the multivitamins as they help with strengthening immunity.
6. Tablet Cetirizine 10 mg is taken one hour before going to sleep for three weeks. Make sure not to go out or drive after taking the tablet, as some individuals may feel sleepy after taking the tablet. It is for reducing itching.
7. Sweating has to be avoided. Make sure to dry the area well with a towel or tissue and keep the body dry. Wear loose clothing and air dry under a fan for a few minutes each day to let the moisture dry up.
8. Make sure nobody at home has similar lesions. If yes, they need to be treated as well. Also, ensure not to share any belongings, including towels, combs, or dresses, with each other as it may spread from person to person.

Consult a specialist doctor, discuss with them, and take medications with their consent

Even a small lesion takes almost a month to completely go away and heal. However, since the lesions are widespread, it would take a few months to completely go off. Therefore consistency is key as it may take some time to heal. Do not worry. It will heal slowly and effectively with proper treatment. However, follow up after four weeks to update me on your progress.

Hope I could be of help.

Stay healthy, happy, and safe.

Get well soon.